Effects of an Aerobic Exercise Program on Cycloergometer Followed by Cold Water Immersion Recovery in Patients With Rheumatoid Arthritis
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 18
- 试验地点
- 1
- 主要终点
- Pressure wave analysis
研究概览
简要总结
The purpose of this study is to analyze the long-term effects of a physical exercise program on the cardiovascular system of people with Rheumatoid Arthritis (RA).
Indeed, it is recognized that RA patients have cardiovascular problems and that regular physical exercise (exercise training) may be beneficial for the disease complications, incluse the cardiovascular risk. Unfortunately, these patients do not exercise enough for fear of joint pain or for fear of deteriorating their general physical condition.
It is known that intermittent exercises, ie combining low and high intensity work phases, are particularly effective in the cardiovascular field. As it is possible that the high intensity phases be more difficult to sustain than the low intensity phases (joint pain and degradation of the inflammatory status), the investigators propose to study the effects of cold water immersion in the legs after performing this exercise, because the cold being recognized as limiting the pain and improving the inflammatory status.
详细描述
The first visit or selection visit, will be the opportunity for the investigator to submit the Information Notice and Informed Consent about. A second visit or visit of inclusion will be the occasion of the return of the signed informed consent of the subject. This visit will include a clinical examination for the detection of a pathology likely to contraindicate the practice of a physical activity and a resting electrocardiogram. The investigator will record the data for each subject, and check the eligibility criteria. Patient's treatments will not be interrupted throughout the program.
The typical rehabilitation sessions will be performed according to the intermittent exercise followed by a cold water immersion recovery at 17 ° Celsius for 15 minutes. The total duration of the rehabilitation session will be approximately 50 minutes and the sessions should be separated by at least 48 hours with a frequency of 3 sessions per week by 6 weeks, totalizing 17 sessions.
The typical sessions will be conducted as follows: intermittent exercise on a cycle ergometer for 30 minutes in sub-maximal intensity; application of the BORG scale; immersion in cold water at 17 ° C for 15 minutes and application of the cold water tolerance scale. The subject's heart rate will be recorded continuously for the duration of the sessions by a heart rate monitor (Polar Electro, Finland).
Intermittent exercise consists of six 5-minute cycles with a succession of work (high: 1 minute, moderate: 4 minutes). The high intensity work phase will be adjusted to achieve a target Heart Rate (HR) corresponding to HR rest + 70% HR reserve (HR reserve = (200 - age) - HR rest). The low intensity work phase will be adjusted to achieve a maximum target HR corresponding to HR rest + 50% HR reserve. In total, the exercise has a sub maximal intensity, commonly used in exercise rehabilitation studies conducted on various pathologies. It is an intensity capable of promoting cardiovascular benefits without representing a severe intensity for the patient.
The target intensity for intermittent work is controlled by monitoring the HR. To achieve the desired , patients will be asked to adjust their pedaling frequency. The patient therefore adapts his pedaling frequency in accordance with the target HR to switch from one workload to another. During the rehab sessions, the wattage and pedaling frequency will be recorded. The cycloergometer used will be of the brand Monark (type 839E).
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Prevention
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 80 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patient (male or female) between the ages of 20 and 80, diagnosed with rheumatoid arthritis without any other risk factor in relation to RA, and having a DAS-28 score between 2.6 and
- •Signature of informed consent
- •Affiliation to a French social security scheme or beneficiary of such a scheme.
排除标准
- •Unstabilized corticosteroids and / or> 10 mg prednisone / day;
- •Unstabilized hypertension;
- •Pregnant women;
- •Alteration of higher functions making comprehension and adherence to a conditioning program impossible (mini mental test <24); Patient who has performed intense physical exercise / physiotherapy within the previous 24 hours the interventions planned in this project;
- •Contraindication to immersion in cold water (a dermatological factor and / or vascular or respiratory cardiac dysfunction and / or cold intolerance syndrome and / or syndrome such as Raynaud's Syndrome);
- •Inability to perform physical exercise, regardless of its origin (neurological, central or peripheral, cardiovascular or respiratory or musculoskeletal);
- •Legal incapacity or limited legal capacity;
- •Subject unlikely to cooperate with the study and / or weak cooperation anticipated by the investigator;
- •Subject without health insurance;
- •Subject being in the exclusion period of another study or provided for by the "National Volunteer File".
研究组 & 干预措施
Exercise followed cold water immersion
Exercise program on cycloergometer and its submerged recovery
干预措施: Exercise followed cold water immersion (Other)
结局指标
主要结局
Pressure wave analysis
时间窗: Week 6
The tonometry device measures brachial arterial pressures and assessment of compliance of large and small arteries. This device records the shape of the pulse wave at the level of the radial artery using a sensor placed on the wrist (non-invasive measurement): the analysis of the shape of this wave makes it possible to obtain information on the compliance blood. The device includes a brachial cuff that makes it possible to measure arterial pressures simultaneously with the measurement of arterial stiffness. The systolic and diastolic blood pressure values will be collected at each resting phase. This pressure wave analysis will be analysed concomitantly with assessment of central arterial compliance (pulse wave velocity measurement) as a composite outcome of the assessment of arterial compliance in patients following the rehabilitation protocol .
Assessment of central arterial compliance
时间窗: Week 6
The assessment of central arterial compliance will be performed by measuring the pulse wave velocity on the carotid-femoral segment. The evaluation of the arterial compliance of the territories concerned (legs) or not (arms) by the exercises, will be carried out by the respective measurements of the pulse wave velocity on the carotid-pedal and carotid-radial segments. This assessment of central arterial compliance (pulse wave velocity measurement) will be analysed concomitantly with pressure wave analysis as a composite outcome of the assessment of arterial compliance.
次要结局
- Cardiovascular function : cardiac index(Week 6)
- Assessment of physical activity (SQUASH)(Week 6)
- Disease activity Score 28(Week 6)
- Disease activity : blood markers of inflammation(Week 6)
- Disease activity : articular ultrasound(Week 6)
- Cardiovascular function : blood pressure(Week 6)
- Cardiovascular function : elasticity of arteries(Week 6)
- Assessment of functional disability : HAQ(Week 6)
- Assessment of quality of life and well-being (SF-36)(Week 6)